AultCare Health Plans Insurance Coverage for Drug and Alcohol Rehab

Health insurance is sometimes the only way that those who suffer from addiction can get the help they need. AultCare Health Plans offers multiple levels of coverage for drug and alcohol rehab.

AultCare Health Plans Insurance Coverage For Drug and Alcohol Rehab

An insurance policy from AultCare Health Plans can help make drug and alcohol rehabilitation affordable by allowing the individual to choose an in-network or out-of-network rehabilitation center.

AultCare coverage for behavioral health treatment includes inpatient and outpatient addiction treatment. In some instances, sober living homes may also be covered so that the individual can safely adjust to life in sobriety after finishing a treatment program.

AultCare Health Plans offers three coverage levels, including bronze, silver and gold. For those who are on a tight budget, a bronze plan with lower monthly premiums may meet their needs. For those who’d prefer to pay less out-of-pocket for rehabilitation services but who can afford a higher monthly premium, a gold plan may be a better match.

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AultCare Bronze 7350 Select

  • Yearly Deductible: $7,350
  • Out-Of-Pocket Maximum: $7,350
  • In-Network Copay: no coinsurance for most services
  • Out-Of-Network Copay: no coinsurance for most services

Drug And Alcohol Detox Coverage

The AultCare Bronze 7350 Select health insurance plan covers drug and alcohol detox for those with a substance use disorder. Individuals can choose an in-network or out-of-network provider for inpatient or outpatient detox. AultCare may cover up to 100 percent of the services.

Inpatient Rehab Coverage

Inpatient rehabilitation for addiction is covered under the AultCare Bronze 7350 Select health insurance plan. This type of addiction treatment is provided in a 24-hour residential setting. Treatment is usually classified as short-term or long-term, and AultCare may cover up to 100 percent of the costs incurred when treatment is preauthorized.

Outpatient Rehab Coverage

Outpatient rehabilitation is covered, including visits to substance dependency and mental health care providers as well as 12-step and group therapy programs. Individuals can expect AultCare to cover up to 100 percent of the costs for outpatient substance use disorder rehabilitation services.

Coverage For Medication-Assisted Treatment

AultCare may cover up to 100 percent of the cost of Diskets (methadone) and Suboxone (buprenorphine, naloxone) as well as other drugs used for medication-assisted treatment under this plan’s drug coverage provisions. These medications prevent withdrawal and help to discourage relapse.

Coverage For Sober Living Houses

Sober living homes are a great option for individuals who have completed a short-term or long-term inpatient treatment program for a substance use disorder. These homes provide a drug- and alcohol-free living environment while the individual adjusts to life in sobriety. To determine whether a stay in a sober living home is covered by this insurance plan, it is best to speak with the preferred sober living home as well as AultCare.

AultCare Silver 6850 Select

  • Yearly Deductible: $6,850
  • Out-Of-Pocket Maximum: $6,850
  • In-Network Copay: Copays and coinsurance amounts vary from $10 to 30 percent, depending on the service
  • Out-Of-Network Copay: 20 percent coinsurance for most services

Drug And Alcohol Detox Coverage

Drug and alcohol detox services are covered under the AultCare Silver 6850 Select health insurance plan. Individuals can choose between inpatient and outpatient rehabilitation centers, and coverage amounts are provided for both in-network and out-of-network providers. However, using out-of-network providers will result in higher out-of-pocket expenses.

Inpatient Rehab Coverage

Short-term and long-term inpatient rehabilitation services for substance use disorder are covered under the AultCare Silver 6850 Select insurance policy. For providers that are in-network, AultCare may cover 100 percent of the treatment services. If an out-of-center rehabilitation facility is chosen, the individual can expect to pay 20 percent for coinsurance. Preauthorization is required for inpatient drug and alcohol addiction treatment services.

Outpatient Rehab Coverage

Outpatient rehabilitation, including individual and group counseling and therapy, are covered under the AultCare Silver 6850 Select insurance policy. Individuals can expect to pay $10 per visit for the first four visits. After the first four visits, there is no coinsurance or copayment required. Preauthorization is not required for outpatient treatment.

Coverage For Medication-Assisted Treatment

Medication-assisted treatment to prevent withdrawal and minimize cravings may be covered under the plan’s prescription drug provisions. Individuals can expect to pay $10 to 30 percent for brand-name and generic medications. Deductibles may apply for certain types of medications.

Coverage For Sober Living Houses

AultCare may cover sober living homes for individuals who need time to adjust to sobriety after they’ve finished their initial treatment program. To determine coverage amounts and limitations, the individual should contact AultCare as well as the sober living house in question.

AultCare Gold 750 Select

  • Yearly Deductible: $750
  • Out-Of-Pocket Maximum: $6,000 in-network, $22,050 out-of-network
  • In-Network Copay: Copay amounts vary according to the service, usually between $5 and $250
  • Out-Of-Network Medical Services: Coinsurance is typically 40 percent

Drug And Alcohol Detox Coverage

Inpatient and outpatient drug and alcohol detox are covered under the AultCare Gold 750 Select health insurance plan. Detox services at both in-network and out-of-network treatment centers are covered. However, individuals will pay less out-of-pocket for treatment centers that are in-network.

Inpatient Rehab Coverage

Inpatient treatment centers for substance use disorder are covered. These facilities provide 24-hour residential treatment to help individuals recover in a safe, supported environment.

Residential treatment services are covered at 80 percent with preauthorization for an in-network provider. If an out-of-network provider is chosen, AultCare may pay up to 60 percent of the cost.

Outpatient Rehab Coverage

Outpatient rehabilitation, including visits to therapists and counselors, are covered. Each office visit is $20. Other outpatient services require a 20 percent coinsurance for in-network providers and 40 percent for out-of-network providers.

Coverage For Medication-Assisted Treatment

For individuals who would benefit from medications like Diskets (methadone), Suboxone (buprenorphine, naloxone) or other FDA-approved medications, AultCare may cover some of the costs associated with these medications. Copayments usually range between $10 and 50 percent.

Coverage For Sober Living Houses

Sober living homes may be covered under the AultCare Gold 750 Select health insurance plan. To determine if coverage is available and the associated coverage amounts, as well as any applicable copay and coinsurance amounts, the individual should speak with AultCare as well as the preferred sober living house.

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In-Network Vs. Out-Of-Network Insurance Coverage

AultCare offers coverage for both in-network and out-of-network providers. In-network providers are those who have a pricing agreement with the insurance company for covered individuals, which results in higher coverage amounts and lower out-of-pocket expenses.

Out-of-network providers do not have a contract or agreement with the insurance carrier, which means out-of-pocket costs are typically higher. To help keep out-of-pocket costs as low as possible, it’s usually preferable to choose an in-network provider.

How To Find Drug And Alcohol Rehab Centers That Accept AultCare Health Plans

  1. Contact Addiction Campuses for an immediate verification of benefits. Addiction Campuses can answer questions about insurance and addiction treatment and perform a no-obligation verification of insurance benefits on your behalf.
  2. Contact the insurance provider by using the phone number on the back of the insurance card or by visiting the provider’s website. A representative will be able to match you to an in-network drug and alcohol rehab center.
  3. Call the treatment center you or your loved one is interested in. The treatment center’s admissions team can answer questions about covered services.

Sources:

AultCare — Bronze 7350 Select
AultCare — Silver 6850 Select
AultCare — Gold 750 Select

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